Provider Demographics
NPI:1265224448
Name:FLORENCE, EMMA NICOLE (MS, LPCA)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:NICOLE
Last Name:FLORENCE
Suffix:
Gender:F
Credentials:MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 FARMER LN
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-1903
Mailing Address - Country:US
Mailing Address - Phone:214-926-8580
Mailing Address - Fax:
Practice Address - Street 1:1102 S ROCK ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6750
Practice Address - Country:US
Practice Address - Phone:972-755-1675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional